Pituitary spindle cell oncocytoma: illustrative case

Area of Science:

• Endocrinology
• Neurosurgery
• Pathology

Background:

• Spindle cell oncocytoma (SCO) is an extremely rare, nonfunctional World Health Organization grade I pituitary tumor.
• SCOs are frequently misdiagnosed as nonfunctional pituitary adenomas based on preoperative imaging.
• These tumors are often hypervascular and locally adherent, posing surgical challenges and increasing recurrence risk.

Purpose of the Study:

• To report a case of pituitary gland spindle cell oncocytoma (SCO).
• To review current literature on SCO diagnosis and management.
• To emphasize the importance of careful surgical technique and follow-up for SCO.

Main Methods:

• A case of SCO treated at the institution was presented.
• Literature review on SCO characteristics, diagnosis, and treatment was performed.
• Endoscopic transsphenoidal resection was utilized for tumor removal.

Main Results:

• Endoscopic transsphenoidal resection achieved total tumor removal despite local adherence.
• Postoperative visual symptoms improved.
• Secondary adrenal insufficiency and hypothyroidism persisted post-surgery.

Conclusions:

• Careful resection is crucial due to SCO's hypervascularity and adherence to minimize damage to surrounding structures.
• Long-term follow-up is recommended due to the tumor's tendency for recurrence.
• Accurate preoperative diagnosis remains a challenge.